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Refer a Patient

Brookings Health System accepts patient referrals from other providers for the following list of services. Please click on each service for information on how to refer a patient. If you have any questions, please contact Central Scheduling at (605) 696-8888 or the contact number listed for each service.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Discharge Date

Insurance

Hometown

History and Physical

Pulmonary or Cardiac

Supporting Documentation

Primary Physician

Cardiologist

Surgeon

Referral Site Phone Number

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

No referral is required for foot care. If you would like us to contact the patient to setup an initial appointment, please send the following:

Patient Name

Date of Birth

Patient Phone Number

Please fax the information to Central Scheduling at (605) 696-8889 or e-mail centralscheduling@brookingshealth.org. Patients may also directly setup their own appointment by calling Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Referring Provider Phone Number

Service Request (Home Health, Hospice or HEARTH)

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Referring Provider Phone Number

Service Requested (Home Health, Hospice or HEARTH)

Please fax the order to Home Services at (605) 696-8832. Questions may be directed to Home Health & Hospice Director at (605) 696-8090.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Dosage and How Long

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient/Representative Phone Number

Diagnosis

Payer Source: Medicare, Medicaid or Private

Physician Order

List of Current Medications

Recent History and Physical

Please fax the order to the Social Worker at (605) 696-8709 or call (605) 696-8714.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Patient Weight

Type of Scan

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8061. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patients may walk-in with a signed doctor order for lab work at any time. Walk-in patients should present their signed order to the Emergency Department receptionist.

Formal referrals require:

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Lab Tests to be Performed

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Laboratory at (605) 696-8048.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8061. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Test Type (PFT, Mask Fitting, Pulmonary Screening)

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient/Representative Phone Number

Diagnosis

Payer Source: Medicare, Medicaid or Private

Physician Order

List of Current Medications

Recent History and Physical

Please fax the order to the Social Worker at (605) 696-8709 or call (605) 696-8714.

Order Requirements

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Rehab/Therapy Services at (605) 696-8061. Questions may be directed to Rehab/Therapy Services at (605) 696-8060.

Order Requirements

Swing Bed patient referrals can be made by calling the Case Management department at (605) 696-8016. You may also fax a patient referral to (605) 696-8803. Information needed includes:

Patient Name

Contact Information for Person Making the Referral

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Type of Scan

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Insurance Authorization

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.

Order Requirements

Patient Name

Date of Birth

Patient Phone Number

Diagnosis

Type of Scan

Insurance Authorization

Physician Signature

Please fax the order to Central Scheduling at (605) 696-8889 or send a scanned, signed order to centralscheduling@brookingshealth.org. Questions may be directed to Central Scheduling at (605) 696-8888.